Coding Quality Auditor and Specialist, HB Coding Remote

Coding Quality Auditor and Specialist, HB Coding, Full-time, Days (Remote)

At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As part of our team, you’ll have the opportunity to contribute to better health care across the Northwestern Medicine system. We offer competitive benefits including tuition reimbursement and loan forgiveness, 401(k) matching, and lifecycle benefits.

The Coding Quality Auditor and Specialist reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and regulatory standards. This role is the expert in clinical documentation and coding, working with the Clinical Documentation Team to ensure quality metrics meet high standards for NM Health System.

The Coding Quality Auditor and Specialist ensures that coding guidelines and regulations are respected during decisions related to clinical documentation and coding. The role partners with Clinical Documentation Nurses, Physicians, and other licensed providers to improve documentation quality and support accurate representation of care. The Specialist also collaborates with the CMOs to maintain the integrity of Health Records through best practices in Clinical Documentation and Coding.

This role maintains quality work queues and reports and engages in advanced and complex projects including risk adjustment, mortality review, hospital acquired conditions (HAC) and patient safety indicators (PSI) review, quality abstraction and analysis, and other special projects. Incumbents demonstrate mastery of advanced clinical documentation integrity and quality concepts, identify root causes, and deliver measurable results. A key part of the role is leading and facilitating quality initiatives and external rankings initiatives while staying compliant with coding guidelines and regulations.

The Coding Quality Auditor and Specialist applies advanced knowledge of the national quality agenda and clinical documentation integrity to advance problem analysis and process improvement for Northwestern Medicine.

This position is 100% remote (occasional onsite meeting attendance may be requested).

• Collaborates with the clinical documentation team to review inpatient accounts with emphasis on mortality reviews and identify documentation improvement opportunities.
• Assess DRG, primary diagnosis (P Dx), secondary diagnosis, PCS, POA, and all other components affecting quality metrics.
• Ensure coding practices remain compliant with coding guidelines and regulations.
• Continually identify educational opportunities related to coding and documentation.
• Act as an expert educator to clinical teams and medical staff.
• Identify strategic plans to positively impact the clinical dashboard.
• Develop clinical relationships across the health system to secure interdepartmental support for education strategies and achievement of targets.
• Multi-task a variety of audits and analyze data to create action plans.
• Develop teaching tools to promote quality outcomes and participate in clinical and executive meetings as identified.
• Demonstrate advanced understanding of quality metrics for health systems (Vizient, PSI, USNWR).
• Apply knowledge of clinical documentation and coding to national quality and ranking methodologies and assist leadership in implementing key strategies to effect change.
• Coordinate with Coding, Clinical Documentation leadership, and Medical Directors to execute advanced project work including mortality review, HAC/PSI review, and quality abstraction and analysis.
• Collaborate with NM departments (IT, Analytics, Innovation) to design and implement new workflow solutions.
• Partner with third-party consultants to contribute to workflow and methodology development as needed.

• RHIT or RHIA or CCS Certification
• Certified Clinical Documentation Specialist
• Bachelor’s Degree in a healthcare field or an Associate’s Degree with five+ years of healthcare coding experience
• Clinical…